--- title: Adopting Risk Adjustment as a Pathway to Improve Health Outcomes Post-COVID description: In the post-COVID landscape, adopting risk adjustment methodology holds the key to improving care quality by identifying opportunities to close the care gaps fueled by the pandemic. image: https://insights.vitaldatatechnology.com/hubfs/Adopting%20Risk%20Adjustment.jpg --- [![Vital Data Technology Logo](https://insights.vitaldatatechnology.com/hs-fs/hubfs/VitalData_Main%20Logo.png?width=2793&height=595&name=VitalData_Main%20Logo.png "Vital Data Technology Logo")](https://vitaldatatechnology.com/) - [Home](https://vitaldatatechnology.com/) - [Solutions](https://vitaldatatechnology.com/solutions/) - Affinitē Clinical Workflows - [Care Management (CM)](https://vitaldatatechnology.com/care-management/) - [Utilization Management (UM)](https://vitaldatatechnology.com/utilization-management/) - [Affinitē Benefit Query Engine (BQE)](https://vitaldatatechnology.com/benefit-query-engine/) - [Quality Improvement (QI)](https://vitaldatatechnology.com/quality-improvement/) - [Appeals & Grievances (AG)](https://vitaldatatechnology.com/appeals-grievances/) - [Affinitē Intelligent Insights](https://vitaldatatechnology.com/intelligent-insights/) - [Predictive Insights](https://vitaldatatechnology.com/predictive-insights/) - [Population Health Analytics](https://vitaldatatechnology.com/population-health-analytics/) - [Care Gap Analytics](https://vitaldatatechnology.com/care-gap-analytics/) - [Risk Analytics](https://vitaldatatechnology.com/risk-analytics/) - [Affinitē Platform](https://vitaldatatechnology.com/affinite-platform/) - [Analytics + Execution](https://vitaldatatechnology.com/analytics-plus-execution/) - [Intelligent Automation](https://vitaldatatechnology.com/intelligent-automation/) - [Health Data Management](https://vitaldatatechnology.com/health-data-management/) - [Member and Provider Engagement](https://vitaldatatechnology.com/provider-member-engagement/) - [Who We Serve](https://vitaldatatechnology.com/who-we-serve/) - Company - [About Us](https://vitaldatatechnology.com/about-us/) - [Careers](https://vitaldatatechnology.com/careers/) - [Privacy Policy](https://vitaldatatechnology.com/privacy-policy/) - [Resources](https://vitaldatatechnology.com/resources/) - [Blog](https://insights.vitaldatatechnology.com/) - [Videos](https://vitaldatatechnology.com/videos/) - [Solution Briefs](https://vitaldatatechnology.com/solution-briefs/) - [Contact Us](https://vitaldatatechnology.com/contact-us/) [December 7, 2021](https://insights.vitaldatatechnology.com/author/vital-data-technology) [COVID](https://insights.vitaldatatechnology.com/tag/covid), [Risk Adjustment](https://insights.vitaldatatechnology.com/tag/risk-adjustment) # Adopting Risk Adjustment as a Pathway to Improve Health Outcomes Post-COVID ![Adopting Risk Adjustment](https://insights.vitaldatatechnology.com/hs-fs/hubfs/Adopting%20Risk%20Adjustment.jpg?width=702&name=Adopting%20Risk%20Adjustment.jpg) Healthcare utilization plummeted immediately and discernably in early 2020, almost entirely due to consumer and provider concerns about COVID transmission. From March to mid-July 2020, [52% of the 1,055 respondents](https://publichealth.jhu.edu/2021/survey-frequent-reports-of-missed-medical-care-in-us-adults-during-the-early-phase-of-the-covid-19-pandemic) in a Johns-Hopkins University COVID-19 Civic Life and Public Health Survey admitted to delaying care due to concerns about transmission. Not unrelated, and not surprisingly, the Medical Group Management Association found that [Covid-19 had a negative financial impact on 97% of the 724 medical practices it surveyed](https://jamanetwork.com/journals/jama/fullarticle/2767633). Care delay and care avoidance were costly to health plans over the past two years, especially to risk- and value-based care health plans. COVID-related deaths diluted risk scores, leading to reduced reimbursements for the 2021 plan year and confounding the process of projecting care costs in 2022. As we begin to return to a new normal, how can health plans and providers offset some of their losses and prepare for future COVID waves? Some answers lie in the confluence of risk adjustment and quality management. ## **The Value of Risk Adjustment to Quality in the Post-Pandemic Landscape** Risk adjustment is a methodology that adjusts plan payments based on members' health status, removing penalties for patient and population risk factors. But several waves of high COVID transmission in 2020 and 2021 caused immediate and necessary reductions in the availability and utilization of non-COVID related healthcare that still have not yet fully rebounded. As a result, early diagnosis and treatment opportunities have been missed, and diseases have progressed in the absence of ongoing care management. Now, providers are scrambling to prioritize and address backlogged care needs and often diagnosing conditions in later, less easily treatable stages that require costlier care. Delayed care also introduces payment dissonance for health plans and providers in value-based arrangements. Costs must be paid upfront, but risk adjusted revenue is paid the following year.  Closing gaps in care is at the heart of quality care delivery. And as a plan’s understanding of its at-risk members and populations grows, its opportunities to improve care delivery also expand. It relies on the transparent and actionable care need intelligence that risk adjustment methodology provides. Because the heart of risk adjustment lies in the capture and analytics of timely, accurate and robust patient data, it holds the key to improving care quality by identifying opportunities to close the care gaps fueled by COVID-19 before members’ conditions worsen further. And it provides a means to pay for needed member care. For this reason, a robust set of risk adjustment analytics tools that works in harmony with quality improvement goals is an absolute must for any plan seeking to get back on track with preventive care and care management and recovering revenue loss in the wake of COVID-related care avoidance. ## **Data Informed Risk Adjustment is Critical to Post-COVID Care Management** Avoiding (or at least mitigating the impact of) the high cost of avoided and delayed care comes down to identifying and prioritizing care for high-need patients while maintaining the current health of all members. By allocating resources according to the member’s current care needs, plans and providers can also significantly reduce costs by preventing and/or slowing the need for costlier care down the road. And this, in turn, improves outcomes through preventive care, early intervention and care management. But all of this is next to impossible in today’s healthcare landscape without reliable, accurate, timely, actionable real-time data capabilities that reveal which members are most in need of preventive care and early care management interventions. Vital Data Technology's Affinitē Risk Adjustment solution provides real-time reporting and streamlined chart retrieval, coding and encounters submission processes that ease the data submission burden on providers while also giving payers and providers the insights they need to prioritize engagements and interventions. It works seamlessly on the Affinitē platform alongside Affinitē Quality Improvement and Management to increase transparency and interoperability between risk adjustment and quality teams and deliver higher ROI – even in a complex healthcare landscape made more complicated by the pandemic. If you have any questions about this article or want to learn more, click below to talk with one of our Risk Adjustment experts. [![Have questions about this article? Reach out now!](https://hubspot-no-cache-na2-prod.s3.amazonaws.com/cta/default/6044692/aa59a93e-f365-4afb-8939-04643d51149f.png)](https://hubspot-cta-redirect-na2-prod.s3.amazonaws.com/cta/redirect/6044692/aa59a93e-f365-4afb-8939-04643d51149f) Previous post [4 Steps Medicare Advantage Plans Should Take to Succeed in a Highly Competitive Market](https://insights.vitaldatatechnology.com/steps-medicare-advantage-plans-should-take-to-succeed) Next post [Affinitē QI Receives AMP Measure Certification for MY 2021](https://insights.vitaldatatechnology.com/affinitē-qi-amp-certification-2021) ### Recent Posts - [Beyond Predictive Analytics: Why Health Plans Need an Operating Model for AI](https://insights.vitaldatatechnology.com/beyond-predictive-analytics-why-health-plans-need-an-operating-model-for-ai) - [Preparing for HEDIS® MY 2027: Five Trends Every Health Plan Should Be Planning for Now](https://insights.vitaldatatechnology.com/preparing-for-hedis-my-2027-five-trends-every-health-plan-should-be-planning-for-now) - [Vital Data Technology Achieves NCQA HEDIS® MY 2026 Certification](https://insights.vitaldatatechnology.com/vital-data-technology-achieves-ncqa-hedis-my-2026-certification) - [Beyond Silos: Why the Next Generation of Value-Based Care Depends on Integrating UM, Care Management, and Payment Integrity](https://insights.vitaldatatechnology.com/beyond-silos-why-the-next-generation-of-value-based-care-depends-on-integrating-um-care-management-and-payment-integrity) - [The Shift Left Imperative: Why the Future of Value-Based Care Starts Before the Visit](https://insights.vitaldatatechnology.com/the-shift-left-imperative-why-the-future-of-value-based-care-starts-before-the-visit) ### Archives - [December 2021 (4)](https://insights.vitaldatatechnology.com/archive/2021/12) - [July 2025 (4)](https://insights.vitaldatatechnology.com/archive/2025/07) - [May 2021 (3)](https://insights.vitaldatatechnology.com/archive/2021/05) - [March 2022 (3)](https://insights.vitaldatatechnology.com/archive/2022/03) - [November 2022 (3)](https://insights.vitaldatatechnology.com/archive/2022/11) - [December 2022 (3)](https://insights.vitaldatatechnology.com/archive/2022/12) - [December 2024 (3)](https://insights.vitaldatatechnology.com/archive/2024/12) - [February 2025 (3)](https://insights.vitaldatatechnology.com/archive/2025/02) - [September 2025 (3)](https://insights.vitaldatatechnology.com/archive/2025/09) - [January 2026 (3)](https://insights.vitaldatatechnology.com/archive/2026/01) - [March 2026 (3)](https://insights.vitaldatatechnology.com/archive/2026/03) - [May 2026 (3)](https://insights.vitaldatatechnology.com/archive/2026/05) - [June 2026 (3)](https://insights.vitaldatatechnology.com/archive/2026/06) - [July 2026 (3)](https://insights.vitaldatatechnology.com/archive/2026/07) - [March 2021 (2)](https://insights.vitaldatatechnology.com/archive/2021/03) - [July 2021 (2)](https://insights.vitaldatatechnology.com/archive/2021/07) - [October 2021 (2)](https://insights.vitaldatatechnology.com/archive/2021/10) - [January 2022 (2)](https://insights.vitaldatatechnology.com/archive/2022/01) - [April 2022 (2)](https://insights.vitaldatatechnology.com/archive/2022/04) - [July 2022 (2)](https://insights.vitaldatatechnology.com/archive/2022/07) - [August 2022 (2)](https://insights.vitaldatatechnology.com/archive/2022/08) - [July 2024 (2)](https://insights.vitaldatatechnology.com/archive/2024/07) - [August 2024 (2)](https://insights.vitaldatatechnology.com/archive/2024/08) - [January 2025 (2)](https://insights.vitaldatatechnology.com/archive/2025/01) - [March 2025 (2)](https://insights.vitaldatatechnology.com/archive/2025/03) - [April 2025 (2)](https://insights.vitaldatatechnology.com/archive/2025/04) - [June 2025 (2)](https://insights.vitaldatatechnology.com/archive/2025/06) - [August 2025 (2)](https://insights.vitaldatatechnology.com/archive/2025/08) - [December 2025 (2)](https://insights.vitaldatatechnology.com/archive/2025/12) - [February 2026 (2)](https://insights.vitaldatatechnology.com/archive/2026/02) - [September 2020 (1)](https://insights.vitaldatatechnology.com/archive/2020/09) - [October 2020 (1)](https://insights.vitaldatatechnology.com/archive/2020/10) - [November 2020 (1)](https://insights.vitaldatatechnology.com/archive/2020/11) - [January 2021 (1)](https://insights.vitaldatatechnology.com/archive/2021/01) - [February 2021 (1)](https://insights.vitaldatatechnology.com/archive/2021/02) - [June 2021 (1)](https://insights.vitaldatatechnology.com/archive/2021/06) - [November 2021 (1)](https://insights.vitaldatatechnology.com/archive/2021/11) - [February 2022 (1)](https://insights.vitaldatatechnology.com/archive/2022/02) - [June 2022 (1)](https://insights.vitaldatatechnology.com/archive/2022/06) - [October 2022 (1)](https://insights.vitaldatatechnology.com/archive/2022/10) - [April 2023 (1)](https://insights.vitaldatatechnology.com/archive/2023/04) - [May 2023 (1)](https://insights.vitaldatatechnology.com/archive/2023/05) - [June 2023 (1)](https://insights.vitaldatatechnology.com/archive/2023/06) - [August 2023 (1)](https://insights.vitaldatatechnology.com/archive/2023/08) - [September 2023 (1)](https://insights.vitaldatatechnology.com/archive/2023/09) - [October 2023 (1)](https://insights.vitaldatatechnology.com/archive/2023/10) - [November 2023 (1)](https://insights.vitaldatatechnology.com/archive/2023/11) - [January 2024 (1)](https://insights.vitaldatatechnology.com/archive/2024/01) - [February 2024 (1)](https://insights.vitaldatatechnology.com/archive/2024/02) - [March 2024 (1)](https://insights.vitaldatatechnology.com/archive/2024/03) - [April 2024 (1)](https://insights.vitaldatatechnology.com/archive/2024/04) - [May 2024 (1)](https://insights.vitaldatatechnology.com/archive/2024/05) - [June 2024 (1)](https://insights.vitaldatatechnology.com/archive/2024/06) - [September 2024 (1)](https://insights.vitaldatatechnology.com/archive/2024/09) - [October 2024 (1)](https://insights.vitaldatatechnology.com/archive/2024/10) - [November 2024 (1)](https://insights.vitaldatatechnology.com/archive/2024/11) - [May 2025 (1)](https://insights.vitaldatatechnology.com/archive/2025/05) - [April 2026 (1)](https://insights.vitaldatatechnology.com/archive/2026/04) See all ### Categories - [intelligent automation](https://insights.vitaldatatechnology.com/tag/intelligent-automation) - [Quality Improvement](https://insights.vitaldatatechnology.com/tag/quality-improvement) - [Artificial Intelligence](https://insights.vitaldatatechnology.com/tag/artificial-intelligence) - [Care Management](https://insights.vitaldatatechnology.com/tag/care-management) - [Data Science](https://insights.vitaldatatechnology.com/tag/data-science) - [AI](https://insights.vitaldatatechnology.com/tag/ai) - [Utilization Management](https://insights.vitaldatatechnology.com/tag/utilization-management) - [HEDIS](https://insights.vitaldatatechnology.com/tag/hedis) - [Industry Insight](https://insights.vitaldatatechnology.com/tag/industry-insight) - [Intelligent Prior Authorization](https://insights.vitaldatatechnology.com/tag/intelligent-prior-authorization) - [News](https://insights.vitaldatatechnology.com/tag/news) - [Population Health](https://insights.vitaldatatechnology.com/tag/population-health) - [Healthcare Payer](https://insights.vitaldatatechnology.com/tag/healthcare-payer) - [Predictive Models](https://insights.vitaldatatechnology.com/tag/predictive-models) - [Risk Adjustment](https://insights.vitaldatatechnology.com/tag/risk-adjustment) - [Medicare Advantage](https://insights.vitaldatatechnology.com/tag/medicare-advantage) - [NCQA](https://insights.vitaldatatechnology.com/tag/ncqa) - [Predictive Analytics](https://insights.vitaldatatechnology.com/tag/predictive-analytics) - [Agentic AI](https://insights.vitaldatatechnology.com/tag/agentic-ai) - [Prior Authorization](https://insights.vitaldatatechnology.com/tag/prior-authorization) - [Behavioral Health](https://insights.vitaldatatechnology.com/tag/behavioral-health) - [Medicare](https://insights.vitaldatatechnology.com/tag/medicare) - [Payer Industry Trends](https://insights.vitaldatatechnology.com/tag/payer-industry-trends) - [Social Determinants of Health](https://insights.vitaldatatechnology.com/tag/social-determinants-of-health) - [Value-Based Care](https://insights.vitaldatatechnology.com/tag/value-based-care) - [Appeals & Grievances](https://insights.vitaldatatechnology.com/tag/appeals-grievances) - [CMS-0057-F](https://insights.vitaldatatechnology.com/tag/cms-0057-f) - [COVID](https://insights.vitaldatatechnology.com/tag/covid) - [Cloud-Native Platform](https://insights.vitaldatatechnology.com/tag/cloud-native-platform) - [Interoperability](https://insights.vitaldatatechnology.com/tag/interoperability) - [AI Agents](https://insights.vitaldatatechnology.com/tag/ai-agents) - [AMP Certification](https://insights.vitaldatatechnology.com/tag/amp-certification) - [Care Gaps](https://insights.vitaldatatechnology.com/tag/care-gaps) - [CareFlow Intelligence](https://insights.vitaldatatechnology.com/tag/careflow-intelligence) - [Compliance](https://insights.vitaldatatechnology.com/tag/compliance) - [FHIR](https://insights.vitaldatatechnology.com/tag/fhir) - [Gen AI](https://insights.vitaldatatechnology.com/tag/gen-ai) - [Insights](https://insights.vitaldatatechnology.com/tag/insights) - [Rules Engine](https://insights.vitaldatatechnology.com/tag/rules-engine) - [Staffing Ratios](https://insights.vitaldatatechnology.com/tag/staffing-ratios) - [Star Ratings](https://insights.vitaldatatechnology.com/tag/star-ratings) - [Aii](https://insights.vitaldatatechnology.com/tag/aii) - [Cloud native](https://insights.vitaldatatechnology.com/tag/cloud-native) - [HEDIS Measurement Year 2026](https://insights.vitaldatatechnology.com/tag/hedis-measurement-year-2026) - [Integration](https://insights.vitaldatatechnology.com/tag/integration) - [Medical Loss Ratio](https://insights.vitaldatatechnology.com/tag/medical-loss-ratio) - [Medical Management](https://insights.vitaldatatechnology.com/tag/medical-management) - [Member Engagement](https://insights.vitaldatatechnology.com/tag/member-engagement) - [Provider Engagement](https://insights.vitaldatatechnology.com/tag/provider-engagement) - [Regulations](https://insights.vitaldatatechnology.com/tag/regulations) - [TPAs](https://insights.vitaldatatechnology.com/tag/tpas) ### Subscribe to Our Newsletter [![VitalData_Main Logo](https://insights.vitaldatatechnology.com/hs-fs/hubfs/VitalData_Main%20Logo.png?width=2793&height=595&name=VitalData_Main%20Logo.png "VitalData_Main Logo")](https://vitaldatatechnology.com/) Vital Data Technology is transforming the healthcare ecosystem by empowering healthcare stakeholders with prescriptive insights to improve member health and lower costs. Vital Data Technology leverages embedded, real-time data science, AI, and analytics together to drive intelligent automation through their cloud-based Affinitē platform. #### Follow Us - - #### Recent News - [Beyond Predictive Analytics: Why Health Plans Need an Operating Model for AI](https://insights.vitaldatatechnology.com/adopting-risk-adjustment-post-covid) - [Preparing for HEDIS® MY 2027: Five Trends Every Health Plan Should Be Planning for Now](https://insights.vitaldatatechnology.com/adopting-risk-adjustment-post-covid) - [Vital Data Technology Achieves NCQA HEDIS® MY 2026 Certification](https://insights.vitaldatatechnology.com/adopting-risk-adjustment-post-covid) - [Beyond Silos: Why the Next Generation of Value-Based Care Depends on Integrating UM, Care Management, and Payment Integrity](https://insights.vitaldatatechnology.com/adopting-risk-adjustment-post-covid) - [The Shift Left Imperative: Why the Future of Value-Based Care Starts Before the Visit](https://insights.vitaldatatechnology.com/adopting-risk-adjustment-post-covid) #### Contact Info ###### Address 800 Newport Center Drive, Suite 450 Newport Beach, CA 92660 ###### Phone [(866) 482-8399](tel:%208664828399) ###### Email [info@vitaldatatech.com](mailto:info@vitaldatatech.com) Copyright © 2026 Vital Data Technology POWERED BY VITAL DATA TECHNOLOGY ![](https://ws.zoominfo.com/pixel/61e7005c1fad08001ae33ad3) ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Vital Data Technology", "url" : "https://insights.vitaldatatechnology.com/author/vital-data-technology" }, "dateModified" : "2021-12-07T19:48:56.710Z", "datePublished" : "2021-12-07T19:48:56.000Z", "headline" : "Adopting Risk Adjustment as a Pathway to Improve Health Outcomes Post-COVID", "image" : [ "https://insights.vitaldatatechnology.com/hubfs/Adopting%20Risk%20Adjustment.jpg" ], "mainEntityOfPage" : { "@id" : "https://insights.vitaldatatechnology.com/adopting-risk-adjustment-post-covid", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "https://insights.vitaldatatechnology.com/hubfs/VitalData_Main%20Logo.png" }, "name" : "Vital Data Technology" } } ```